As a sex and relationship therapist, Brandy Engler, Ph.D., has some super-fascinating insights into love and intimacy.

Courtesy of Brandy Engler

Her new book, The Women on My Couch, is filled with stories of her female patients in L.A. — a follow-up to her first book, The Men on My Couch (which was all about her mostly male patient list in New York City). BuzzFeed Life reached out to her about the some of the most common reasons people see her.

WORTH SAYING BEFORE WE GET INTO THIS: Engler's patients are mostly young, cisgender, heterosexual, and living in New York or L.A., so that's who she writes about. They also can afford a sex therapist...and are seeing one for a reason. All that being said, the themes and comparisons listed below likely aren't going to be relevant to everyone. Also, the common experiences of sex therapists who specialize in different gender identities or sexual orientations may be very different.

1.So many people are just going through the motions during sex.

When Engler asks people to describe their last sexual encounter, she hears about a whole lot of lackluster hookups. "A lot of people will describe that nobody has their eyes open, their minds are off somewhere else," she says. "They're not talking during sex, they're not sharing fantasies, they're just going through this mechanical emotionless routine. You can have orgasms that way, but it's not going to motivate you. There's no passion — that's what's missing."

3.When women have low libido, it doesn't always mean they don't want sex at all, they usually just don't want to have sex with their partners.

While low sex drive in men is usually pretty broad, female loss of libido is often partner-specific, says Engler: for instance, when a woman doesn't really feel like having sex with her husband anymore, but still ~feels things~ during Magic Mike XXL or says she wants to cheat with her hot yoga teacher.

4.People actually come to sex therapy to ponder threesomes and other sexual propositions.

And it's usually women who are trying to decide if they should have a threesome or indulge in some fetish or sex act that their partner is into. While Engler obviously doesn't give them the red or green light either way, she can help them figure out what they're comfortable with and if they're willing to go a little (or a lot) out of their comfort zone in this specific situation. Unfortunately, she's noticed that a lot of times people are weighing what's right for them against "a desire to be chill or cool or down."

5.Cuckold and chastity fetishes are kinda big right now.

"Those are fetishes I'm seeing a lot of that was surprising to me," says Engler. (A cuckold fetish is getting turned on by watching your partner with someone else, while a chastity fetish is a type of BDSM play that involves chastity belts or cages.) "It's more common than people think it is, and it's often coming from a place of low self-esteem or trauma or acting something out."

6.Men usually seek help when their penis isn't working, and women usually come in when a sex problem is affecting the relationship.

A missing orgasm or other sexual dysfunction is more likely to send men to sex therapy than women. "[Men] are more self-initiated to come in for sexual problems," she says. "Women often come in when a sexual issue impacts the relationship, not because she is bothered by it."

7.Lots of men want sex to be more meaningful.

That myth about men preferring casual emotionless sex isn't typically what Engler sees in her practice. Most of her patients who come in with libido issues complain of feeling empty or flatlined. They tend to seek out things to make them feel some excitement (like drugs, alcohol, porn, sex services), but what they're often craving is more passion — wanting to really want their partners. "Men want sex to be more meaningful, soulful, and loving than what they're getting," says Engler. "They often don't know how to get there."

8.Engler has noticed a lot more women prioritizing sex over love lately.

Engler says she's noticed a rise in women adopting this nonchalant view of sex and intimacy — whether that's having multiple partners without any serious connections or shrugging off romance in relationships. "They're cutting love out and taking this very transactional and practical view of sex and really feeling like this is feminism and this is what independence truly is," she says.

Whether that's good or bad really isn't up to Engler, but her goal in therapy is to find out what brought them into her office and whether this strategy is more of a defense mechanism than an actual belief system that's working for them.

It's unfortunately not uncommon for Engler to see heterosexual couples where (regardless of their respective jobs) the woman is doing all the cooking and cleaning and is really fucking resentful of that. "The thing that's interesting for me is when I talk to guys about it, they don't often understand how important the household stuff is, how symbolic of equality it is. He usually just thinks, 'Why is she so anal?'" Meanwhile, the women in her practice see it as a turnoff — like they're having to take care of their immature partner. The result: growing animosity that makes no one want to take their clothes off.

10.Tons of people have a problem with porn.

And it's mostly men, at least in her practice. "Here's me as a sex therapist afraid to sound uncool, but the truth about what I'm seeing is what guys are saying to me in confidence: 'I look at it a lot and I prefer it to my wife or girlfriend. It's just better.'" Obviously not all porn-watching is unhealthy, but when it's interfering with their IRL sex life or their ability to get off without it, that's usually when people bring it up in Engler's office.

"Some of it is neurological, the way porn affects the brain and body. Some of it is that the guy started using it at a young age to go to sleep or reduce stress and now is kind of dependent on it. But it also helps guys to not feel self-conscious," says Engler. "They feel pressure to be good in bed and to perform, and they can avoid all that with porn." It’s not that women don’t watch porn — she’s just seeing a lot more men who are struggling with how much they depend on it. “Guys are totally aware when porn is a problem. It’s not like they come in and this female sex therapist is judging them. They’re loath to give it up, but they’re aware.”

11.Single people go to sex and relationship therapy, too.

They'll come in and say they've been on the market for a while and nothing is happening and what is wrong with them, says Engler. In these cases, therapy might involve Engler just getting a sense of how they interact with her and open up to her. "Whatever it is, it's often reflective of their style of attachment, the way they approach people, and whether it's guarded or not." And that can sometimes help them figure out where they're going wrong on dates.